All-cause hospitalisation according to demographic group in people living with HIV in the current ART era: Recent findings from a cohort study in the UK

OBJECTIVE: We investigated differences in all-cause hospitalisation between key demographic groups among people with HIV in the UK in the current ART era. DESIGN/METHODS: We used data from the Royal Free HIV Cohort study between 2007 and 2018. Individuals were classified into five groups: men who have sex with men (MSM), Black African men who have sex with women (MSW), MSW of other ethnicity, Black African women and women of other ethnicity. We studied hospitalisations during the first year after HIV diagnosis (Analysis-A) separately from those more than one year after diagnosis (Analysis-B). In Analysis-A, time to first hospitalisation was assessed using Cox regression adjusted for age and diagnosis date. In Analysis-B, subsequent hospitalisation rate was assessed using Poisson regression, accounting for repeated hospitalisation within individuals, adjusted for age, calendar year, time since diagnosis. RESULTS: The hospitalisation rate was 30.7/100 person-years in the first year after diagnosis and 2.7/100 person-years subsequently; 52% and 13% hospitalisations respectively were AIDS-related. Compared to MSM, MSW and women were at much higher risk of hospitalisation during the first year [aHR (95%CI): 2.7 (1.7-4.3), 3.0 (2.0-4.4), 2.0 (1.3-2.9), 3.0 (2.0-4.5) for Black African MSW; other ethnicity MSW; Black African women; other ethnicity women respectively, Analysis-A] and remained at increased risk subsequently [corresponding aIRR (95% CI): 1.7 (1.2-2.4), 2.1 (1.5-2.8), 1.5 (1.1-1.9), 1.7 (1.2-2.3), Analysis-B]. CONCLUSIONS: In this setting with universal healthcare, substantial variation exists in hospitalisation risk across demographic groups, both in early and subsequent periods after HIV diagnosis, highlighting the need for targeted interventions

Outcomes of total hip arthroplasty, as a salvage procedure, following failed internal fixation of intracapsular fractures of the femoral neck: a systematic review and meta-analysis.

AIMS: The optimal management of intracapsular fractures of the femoral neck in independently mobile patients remains open to debate. Successful fixation obviates the limitations of arthroplasty for this group of patients. However, with fixation failure rates as high as 30%, the outcome of revision surgery to salvage total hip arthroplasty (THA) must be considered. We carried out a systematic review to compare the outcomes of salvage THA and primary THA for intracapsular fractures of the femoral neck. PATIENTS AND METHODS: We performed a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) compliant systematic review, using the PubMed, EMBASE and Cochrane libraries databases. A meta-analysis was performed where possible, and a narrative synthesis when a meta-analysis was not possible. RESULTS: Our analyses revealed a significantly increased risk of complications including deep infection, early dislocation and peri-prosthetic fracture with salvage THA when compared with primary THA for an intracapsular fracture of the femoral neck (overall risk ratio of 3.15). Functional outcomes assessment using EuroQoL (EQ)-5D were not significantly different (p = 0.3). CONCLUSION: Salvage THA carries a significantly higher risk of complications than primary THA for intracapsular fractured neck of femur. Current literature is still lacking well designed studies to provide a full answer to the question. TAKE HOME MESSAGE: Salvage THA is associated with more complications than primary THA for intracapsular neck of femur fractures

Membrane-Spanning DNA Nanopores with Cytotoxic Effect.

DNA-based cytotoxic agents: Nanopores composed of folded DNA featuring a hydrophobic belt of ethyl phosphorothioate groups insert into bilayer membranes and kill cancer cells. The mode by which the pores achieve cell killing is elucidated with confocal microscopy

Generalised Quasilinear Approximation of the Interaction of Convection and Mean Flows in a Thermal Annulus

In this paper, we examine the interaction of convection, rotation and mean flows in a thermal annulus. In this system, mean flows are driven by correlations induced by rotation leading to non-trivial Reynolds stresses. The mean flows act back on the convective turbulence acting as a barrier to transport. For this system, we demonstrate that the generalized quasilinear approximation (Marston et al. 2016 Phys. Rev. Lett.116, 214501. (doi:10.1103/PhysRevLett.116.214501)) may provide a much better approximation to the complicated full nonlinear dynamics than the widely used quasilinear approximation. This result will enable the construction of more accurate statistical theories for the description of geophysical and astrophysical flows

Pollutant dispersion in a developing valley cold-air pool

Pollutants are trapped and accumulate within cold-air pools, thereby affecting air quality. A numerical model is used to quantify the role of cold-air-pooling processes in the dispersion of air pollution in a developing cold-air pool within an alpine valley under decoupled stable conditions. Results indicate that the negatively buoyant downslope flows transport and mix pollutants into the valley to depths that depend on the temperature deficit of the flow and the ambient temperature structure inside the valley. Along the slopes, pollutants are generally entrained above the cold-air pool and detrained within the cold-air pool, largely above the ground-based inversion layer. The ability of the cold-air pool to dilute pollutants is quantified. The analysis shows that the downslope flows fill the valley with air from above, which is then largely trapped within the cold-air pool, and that dilution depends on where the pollutants are emitted with respect to the positions of the top of the ground-based inversion layer and cold-air pool, and on the slope wind speeds. Over the lower part of the slopes, the cold-air-pool-averaged concentrations are proportional to the slope wind speeds where the pollutants are emitted, and diminish as the cold-air pool deepens. Pollutants emitted within the ground-based inversion layer are largely trapped there. Pollutants emitted farther up the slopes detrain within the cold-air pool above the ground-based inversion layer, although some fraction, increasing with distance from the top of the slopes, penetrates into the ground-based inversion layer.Peer reviewe

Light Sneutrino Dark Matter at the LHC

In supersymmetric (SUSY) models with Dirac neutrino masses, a weak-scale trilinear A-term that is not proportional to the small neutrino Yukawa couplings can induce a sizable mixing between left and right-handed sneutrinos. The lighter sneutrino mass eigenstate can hence become the lightest SUSY particle (LSP) and a viable dark matter candidate. In particular, it can be an excellent candidate for light dark matter with mass below ~10 GeV. Such a light mixed sneutrino LSP has a dramatic effect on SUSY signatures at the LHC, as charginos decay dominantly into the light sneutrino plus a charged lepton, and neutralinos decay invisibly to a neutrino plus a sneutrino. We perform a detailed study of the LHC potential to resolve the light sneutrino dark matter scenario by means of three representative benchmark points with different gluino and squark mass hierarchies. We study in particular the determination of the LSP (sneutrino) mass from cascade decays involving charginos, using the mT2 variable. Moreover, we address measurements of additional invisible sparticles, in our case the lightest neutralino, and the question of discrimination against the MSSM.Comment: 25 pages, 16 figure

Physician and Clinical Integration Among Rural Hospitals

The pressures for closer alignment between physicians and hospitals in both rural and urban areas are increasing. This study empirically specifies independent dimensions of physician and clinical integration and compares the extent to which such activities are practiced between rural and urban hospitals and among rural hospitals in different organizational and market contexts. Results suggest that both rural and urban hospitals practice physician integration, although each emphasizes different types of strategies. Second, urban hospitals engage in clinical integration with greater frequency than their rural counterparts. Finally, physician integration approaches in rural hospitals are more common among larger rural hospitals, those proximate to urban facilities, those with system affiliations, and those not under public control.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72074/1/j.1748-0361.1998.tb00637.x.pd

The level set method for the two-sided eigenproblem

We consider the max-plus analogue of the eigenproblem for matrix pencils Ax=lambda Bx. We show that the spectrum of (A,B) (i.e., the set of possible values of lambda), which is a finite union of intervals, can be computed in pseudo-polynomial number of operations, by a (pseudo-polynomial) number of calls to an oracle that computes the value of a mean payoff game. The proof relies on the introduction of a spectral function, which we interpret in terms of the least Chebyshev distance between Ax and lambda Bx. The spectrum is obtained as the zero level set of this function.Comment: 34 pages, 4 figures. Changes with respect to the previous version: we explain relation to mean-payoff games and discrete event systems, and show that the reconstruction of spectrum is pseudopolynomia